CDHA U Phe Quan-Phoi

CHN ON HNH NH
UNG TH PH QUN-PHI
BS. NGUYN QU KHONG
BS. NGUYN QUANG TRNG
KHOA CHN ON HNH NH

BNH ViN AN BNH TP.HCM
11/1/2014
DN BI
11/1/2014
i cng.
Phn loi:
Theo gii phu.
Theo m hc.
Phn loi TNM.
K phi th pht.
DN BI
11/1/2014
i cng.
Phn loi:
Theo gii phu.
Theo m hc.
Phn loi TNM.
K phi th pht.
I CNG
U ph qun-phi rt nguy him, ch c 15% sng st

sau 5 nm.
M, 125.000 ngi/nm cht v U phi.
Nam b nhiu hn N, nhng nay th bnh nhn N
ang ngy cng tng ln.
Bnh thng gp la tui > 40.
Thuc l c xem l mt trong nhng tc nhn gy
Uph qun-phi.
11/1/2014
I CNG
Trong thuc l c Carcinogenic polycyclic

hydrocarbon Epithelial mtaplasia Ung th.
Tn sut U ph qun-phi rt cao nhng ngi ht
20 gi x nm (1 gi/ngy x s nm).
C 3 loi U ph qun-phi:
U lnh: 5% u nguyn pht.
U c: K ph qun-phi: 95% u nguyn pht.
U c th pht: K di cn.
99% K cc ph qun v cc ph nang.
1% K kh qun.
11/1/2014
PHN LOI
1.
2.
Theo gii phu: c hai loi.

a.
Loi trung tm: PQ ln c th b tc Xp phi biu hin triu
chng lm sng sm.
b.
Loi ngoi bin: PQ nh c thi gian yn lng lu chn on tr.
*Tuy nhin khi khi u:
-Loi trung tm c kch thc = 2cm.
-Loi ngoi bin c kch thc = 6mm.
Th i sng ca khi u tri qua.
Theo m hc: c 5 loi chnh.
a.
Ung th t bo vy (squamous cell carcinoma).
b.
Ung th t bo tuyn (adenocarcinoma).
c.
Ung th t bo nh (small cell carcinoma).
d.
Ung th t bo ln (large cell carcinoma).
e.
Ung th tiu ph qun-ph nang (bronchiolo-alveolar carcinoma).
11/1/2014
DN BI
11/1/2014
i cng.
Phn loi:
Theo gii phu.
Theo m hc.
Phn loi TNM.
K phi th pht.
K PH QUN-PHI TH TRUNG TM (80%)
Tn thng nhu m:
Xp phi (atelectasis): thng gp.
Vim phi sau tc nghn (obstructive pneumonia).
p xe phi.
Kh ph thng: 2%.
Trn dch mng phi: 5%
Do tc nghn bch mch.
Do xm ln vo mng phi (trn mu mng phi).
Lit thn kinh honh.
11/1/2014
Vim phi sau tc nghn (obstructive pneumonia):

Hnh nh thng gp trong Ung th ph qun-phi
(thy trong khong 35% bnh nhn b Ung th
biu m squamous cell carcinoma).
Nhu m phi xp v ng c, ph qun dn v lp
y bi dch nhy to nn hnh nh Mucous
bronchogram, thy r trn CT sau chch thuc cn
quang.
Richard Webb et al. Thoracic Imaging-Pulmonary & Cardiovascular Radiology, p66-111. 2005
11/1/2014
Khi u rn phi, thng km theo xp phi to du

hiu ch S o ngc kinh in (S Goldens sign).
11/1/2014
Weissleder et al.Diagnostic Imaging Expert.1998
10
S Goldens sign: Small cell carcinoma

11/1/2014
11
S Goldens sign
Dalia Megiddo,M.D et al. Chest X-ray interpretation. Academia Medica,Jerusalem,ISRAEL.
11/1/2014
12
S Goldens sign
Joseph K.T.Lee. Lee computed body tomography with MRI correlation. 1998
11/1/2014
13
MUCOUS BRONCHOGRAM
11/1/2014
14
S GOLDENS SIGN
MUCOUS BRONCHOGRAM
Jacques Rmy et al. Imagerie Thoracique. Socit Franaise de Radiologie - 2003
11/1/2014
15
TNG QUAN GIA U V PH QUN
Rat-tail sign
Daniel Jeanbourquin et al. Imagerie Thoracique de l'adulte. 2003
11/1/2014
16
11/1/2014
17
Chi trong lng kh qun, ph qun

11/1/2014
18
XC NH XM LN TRUNG THT
Hch trung tht c xem l ph i

khi ng knh theo trc ngn ca
hch 10mm.
11/1/2014
19
Khi u (T) xm ln khoang m trc carina, xm ln TM ch trn vi

huyt khi trong lng (*) (tumor thrombus).
11/1/2014
20
Khi u (T) tip xc vi trung tht > 3cm, xm ln khoang m cnh MC,
tip xc > chu vi MC (cc mi tn). Hch di carina (N).
11/1/2014
21
K PH QUN-PHI TH NGOI BIN (20%)
Tn thng hnh ng tin (coin lesion);

B thng khng u, c mi, hoc c ch lm
vo, hoc c gai.
Tn thng c th vi ha hoc to hang.
Vi ha t gp (thng gp hn vi tn thng
lnh tnh).
To hang 4% vi thnh dy > 16mm, vi nt
vch, khng mc thy-kh.
11/1/2014
22
Nhng du hiu gi c tnh
Sebastian Lange, MD et al. Radiology of Chest Diseases. 2nd Edition, 1998

11/1/2014
23
Spiculated mass vi Pleural tail sign:

adenocarcinoma
11/1/2014
24
Pleural tail sign:

squamous cell carcinoma
11/1/2014
25
B hnh gai, hang thnh dy khng u, pleural tail sign,

air bronchogram: Adenocarcinoma.
11/1/2014
26
Spiculated edge:
adenocarcinoma
11/1/2014
27
Spiculated edge: Squamous cell carcinoma

11/1/2014
28
VI HA LNH TNH
11/1/2014
29
TUBERCULOMA
11/1/2014
30
HAMARTOMA
11/1/2014
31
HAMARTOMA
11/1/2014
32
HISTOPLASMOMA
11/1/2014
33
VI HA KHNG XC NH
(LNH TNH HOC C TNH)
11/1/2014
34
EPIDERMOID CARCINOMA
11/1/2014
35
ADENOCARCINOMA
11/1/2014
36
LIN QUAN GIA KCH THC V C TNH
NG KNH
C TNH
< 1cm
1-2cm
2-3cm
>3cm
35%
50%
80%
97%
11/1/2014
37
S BT THUC CA TN THNG
Tn thng bt thuc < 15HU: gi lnh tnh.

Tn thng bt thuc > 20HU: gi c tnh.
( nhy: 98%, chuyn bit: 73%, chnh xc:
85%)
11/1/2014
Wolfgang Dahnert, MD. Radiology Review Manual. 5thEdition. 2003
38
NH LUT NHN I TH TCH
Th tch ca mt khi u tng gp i khi ng knh

khi u tng 25% (cn khi ng knh tng gp i th
th tch tng gp 8 ln).
Thi gian nhn i th tch < 1 thng: Nhim trng.
Thi gian nhn i th tch 1 thng 1 nm: U c.
Thi gian nhn i th tch > 1 nm: U lnh.
Lu : K tiu ph qun-ph nang c th khng i
th tch trong 1-2 nm u.
11/1/2014
39
NH LUT NHN I TH TCH
1 thng: Ung th t bo nh xm ln (aggressive small cell

cancer).
3 thng: Carcinoma t bo vy (squamous cell carcinoma).
4 thng: Carcinoma t bo ln (large cell carcinoma).
5 thng: Adenocarcinoma xm ln (aggressive
adenocarcinoma).
6 thng: Adenocarcinoma (aggressive adenocarcinoma).
11/1/2014
40
NH LUT NHN I TH TCH
nh lut ny ch c gi tr tin on dng 65% cc trng

hp:
U c tnh pht trin chm: low-grade adenocarcinoma, di
cn t carcinoma thn (renal cell carcinoma).
U c tnh pht trin rt nhanh: Osteosarcoma,
choriocarcinoma, testicular neoplasm.
Lu : Bronchogenic carcinoma c th tm thi gim kch
thc do: nhi mu, hoi t, x ha.
11/1/2014
41
XC NH XM LN THNH NGC
11/1/2014
42
To gc t vi thnh ngc (cc mi tn trng), xa lp m ngoi mng

phi (mi tn en).
11/1/2014
43
Tip xc vi thnh ngc > 3cm, to gc t vi thnh ngc (cc mi tn

trng), hy cung sn (mi tn en).
11/1/2014
44
Tip xc vi thnh ngc L=5cm,

D=5cm. M ngoi mng phi c m
thp, thy cc khong lin sn
(cc mi tn trng),
Hy cung sn v u thnh ngc.
11/1/2014
45
Tip xc vi thnh ngc L=5,6cm, D=8,7cm.
11/1/2014
46
DN BI
11/1/2014
i cng.
Phn loi:
Theo gii phu.
Theo m hc.
Phn loi TNM.
K phi th pht.
47
SQUAMOUS CELL CARCINOMA

- 30% ung th ph qun-phi.
- Lin h nhiu vi thuc l.
- 65% xut pht t ph qun gc, thy, phn thy:
+Khi trong lng ph qun.
+Tc nghn ph qun.
+Thm nhim vch ph qun.
+Xm ln ti ch.
+Khi rn phi.
+Thng gy xp v vim phi sau tc nghn.
- 30% hin din nh mt nt n c hoc mt khi.

+Thng hoi t to hang.
- Thi gian nhn i th tch: 3 thng. Di cn tr.
11/1/2014
- Tin lng tt.
48
U (M) gy xp phi to du hiu S Golden, hch cnh (P)

kh qun (mi tn ln)
11/1/2014
49
U trong lng ph qun thy di (P) (Hnh A). lt ct thp hn (Hnh B): lng
PQ tc nghn, xm ln xung quanh, to nn mt khi rn phi (M).
11/1/2014
50
U rn phi (P), ph i hch trc

carina (mi tn ln).
lt ct thp hn thy u bao bc quanh

ph qun thy trn (P) (mi tn), ph i
hch di carina.
Farnoosh Sokhandon, MD et al. Bronchogenic Squamous Cell Carcinoma. Radiographics.

2003;23:1639-1643.
11/1/2014
51
U to hang thnh dy, c nt vch, ngoi vi thy trn phi (P)

11/1/2014
52
ADENOCARCINOMA
-30-35% ung th ph qun-phi (loi TB thng gp
nht).
-Khng lin h vi thuc l, thng thy nht ph n.
-Thng lin kt vi x phi (lung fibrosis).
-75% hin din nh mt nt n c ngoi vi phi.
-B thng c gai (spiculated).
-Thi gian nhn i th tch 5-6 thng. Di cn sm.
11/1/2014
53
ADENOCARCINOMA
U c b dng mi, pleural tail sign (+): adenocarcinoma

11/1/2014
54
ADENOCARCINOMA
U ngoi vi phi vi b c gai
11/1/2014
55
BRONCHIOLO-ALVEOLAR CARCINOMA
- Subtype ca adenocarcinoma (3% ca K ph qun-phi).
- U khng xm ln.
- 60% hin din nh mt nt n c:
+U khng tit nhy (non-mucinous cell type).
+Gii hn khng r.
+Air bronchogram (+).
+Bng kh thu quang (bubbly lucencies pseudocavitation).

+Tin lng rt tt.
- 40% hin din nh mt vng ng c phi:
+ U tit nhy (mucinous cell type).
+ CT angiogram sign (+).
+ Tin lng xu.
Richard
Webb et al. Thoracic Imaging-Pulmonary & Cardiovascular Radiology, p66-111. 2005
11/1/2014
56
BRONCHIOLOALVEOLAR CARCINOMA
Nt m (mi tn) b khng r do

khng u, c gai. Trn CT thy air
bronchogram v pseudocavitation
11/1/2014
57
Pseudocavitation
Jeremy J. Erasmus, MD et al. Solitary Pulmonary Nodules: Part I. Morphologic Evaluation for
Differentiation of Benign and Malignant Lesions. Radiographics. 2000;20:43-58.
11/1/2014
58
11/1/2014
59
Nhiu nt m khng r b vi air bronchogram
11/1/2014
60
ng c c hai thy trn vi air bronchogram
11/1/2014
61

11/1/2014
62
CT ANGIOGRAM SIGN
l hnh nh mch mu phi tng m , hin r

trn nn phi ng c, gim m .
Trc y du hiu ny c xem l c hiu trong
chn on bronchiolo-alveolar carcinoma. Ngy nay
ngi ta chng minh rng i khi cng c th thy
trong vim phi, ph phi
Roberto L. Maldonado, MD. The CT Angiogram Sign. Radiology. 1999;210:323-324.

11/1/2014
63
CT ANGIOGRAM SIGN
BRONCHIOLOALVEOLAR
CARCINOMA
Roberto L. Maldonado, MD. The CT Angiogram Sign. Radiology. 1999;210:323-324.

11/1/2014
64
CT ANGIOGRAM SIGN
AIR BRONCHOGRAM (+), CT ANGIOGRAM SIGN (+)

J I Jung, MD et al. CT differentiation of pneumonic-type bronchioloalveolar cell carcinoma and
infectious pneumonia. British Journal of Radiology 74 (2001),490-494.
11/1/2014
65
CT ANGIOGRAM SIGN
AIR BRONCHOGRAM (+), CT ANGIOGRAM SIGN (+)
BAC
VIM PHI THY
Rosita M. Shah et al. CT angiogram sign: Incidence and Significance in Lobar Consolidations
Evaluated by Contrast-Enhanced CT. AJR 1998;170:719-722
11/1/2014
66
SMALL CELL CARCINOMA

- 15-20% ung th ph qun-phi.
- Carcinoma thn kinh-ni tit (neuroendocrine),
thng biu hin bng hi chng cn ung th
(paraneoplastic syndrome).
- Phn ln xut pht t ph qun gc hoc ph qun thy.
- Xm ln quanh ph qun.
- Khi ln rn phi hoc cnh rn phi, lm hp lng PQ.
- Ph i hch trung tht.
- Thi gian nhn i th tch: 1 thng. > 90% di cn ti thi
im chn on.
-Tin lng rt xu.
11/1/2014
67
SMALL CELL CARCINOMA
U rn phi (P) , dy vch lin tiu thy thy gia do di cn

theo ng bch huyt ln cn
11/1/2014
68
LARGE CELL CARCINOMA

- 10% ung th ph qun-phi.
- Chng lp nhiu loi t bo khc nhau.

- Thng biu hin bng mt khi ln ngoi vi, > 4cm.
- Thi gian nhn i th tch: 4 thng. Di cn sm.
- Tin lng xu.
11/1/2014
69
LARGE CELL CARCINOMA
Khi u ln phi (T), TDMP (T)
11/1/2014
70
SQUAMOUS
ADENOCARCINOMA
SMALL CELL
LARGE CELL
Nt hoc khi
ngoi vi
30%
75%
15%
65%
Xp phi
40%
10%
20%
15%
ng c phi
20%
15%
20%
25%
Rn phi to
40%
20%
80%
30%
Khi trung
tht
< 5%
< 5%
15%
10%
5%
5%
5%
5%
Trn dch
mng phi
11/1/2014
71
K BIU M
K TB TUYN
K TB NH
V tr
Trung tm (++) Ngoi bin (+)
Ngoi bin (++) Trung tm (-)
Trung tm (+) Ngoi bin (+)
M hc
TB biu m bit ha nhiu hay

t
TB tuyn bit ha nhiu hay

t
TB Kulchitsky (dng la mch)
i th
Chi trong PQ. Hoi t (++).
Khng hnh c hiu.
U thm nhim quanh PQ.
Di cn
-Ln cn
-Theo bch huyt
-Theo ng mu
-Ln cn
-Theo bch huyt
-Theo ng mu
Theo mu di cn vo xng,
trung tht.
Gii, tui
Nam > N. Tui > 50.
N > Nam. Tui 40.
Nam > N. Tui < 40.
X quang
Lin h n
thuc l
Tr liu
11/1/2014
-Phu thut (+).

-X tr (+/-).
-Phu thut (+).

-X tr (+/-).
-Ha tr (+)
+/-
-X tr (+/-).
-Ha tr (+)
72
CC C TNH GI U C TNH
- U thy trn phi.
- ng knh ln nht >2cm.
- B nhe, a cung, khng u, c gai.
- C air bronchogram, nhng bng kh nh (pseudocavitation).
- Hang vch dy > 16mm, c nt vch, khng c mc thy-kh.

- Vi ha dng lm tm hoc lch tm.
- Khng c nt v tinh.
- Bt thuc 20HU.
- Thi gian nhn i th tch t 1 thng n 1 nm.
11/1/2014
73
DN BI
11/1/2014
i cng.
Phn loi:
Theo gii phu.
Theo m hc.
Phn loi TNM.
K phi th pht.
74
PHN LOI TNM

T1
ng knh (ln nht) <3cm, c bao quanh bi phi hoc mng

phi tng.
T2
ng knh (ln nht) >3cm, xm ln mng phi tng, xp phi,

vim phi sau tc nghn, cch carina > 2cm.
T3
U bt k kch thc, cch carina < 2cm, xm ln mng phi thnh,

thnh ngc, vm honh, mng phi trung tht, mng tim, TDMP.
T4
Xm ln tim, mch mu ln, kh qun, thc qun, thn t sng,

carina, TDMP c tnh.
N1
N2
Hch quanh ph qun, rn phi cng bn.
N3
Hch rn phi, trung tht bn i din.
M0
Khng di cn xa.
M1
Di cn xa.
Hch trung tht cng bn.
11/1/2014
75
11/1/2014
76
GIAI ON
TNM
IU TR
IA
T1, N0, M0
Ct b khi u.
IB
T2, N0, M0
Ct b khi u.
IIA
T1, N1, M0
Ct b khi u.
IIB
T2, N1, M0
T3, N0, M0
Ct b khi u.
IIIA
T1, N2, M0
T2, N2, M0
T3, N1, M0
T3, N2, M0
X tr hoc ha tr sau ct b khi u.
IIIB
T1, N3, M0
T2, N3, M0
T3, N3, M0
X tr v/hoc ha tr.
IV
M1
Ha tr.
11/1/2014
77
PHN LOI TNM
U (mi tn) DI CN HCH TRUNG THT

BN I DIN (u mi tn)
11/1/2014
78
PHN LOI TNM
U (M) di cn hch di carina (S), hch trc kh qun (P), hch

trung tht trc (A), hch trung tht bn i din (cc mi tn ln).
Di cn mng phi gy dy v TDMP (cc mi tn nh).
11/1/2014
79
PHN LOI TNM
UNG TH PH QUN-PHI TO HANG (cc mi tn)

GIAI ON IV
11/1/2014
80
PHN LOI TNM
UNG TH PH QUN-PHI GIAI ON IV
11/1/2014
81
S GIN N XC NH GIAI ON UNG TH PH QUN-PHI
11/1/2014
82
DN BI
11/1/2014
i cng.
Phn loi:
Theo gii phu.
Theo m hc.
Phn loi TNM.
K phi th pht.
83
UNG TH PHI TH PHT
C ba loi:
K di cn ln phi theo ng mch mu.
K di cn ln phi theo ng bch huyt.
K di cn theo ng ph qun.
11/1/2014
84
UNG TH PHI TH PHT

DI CN THEO NG MU
Hnh nh bong bng bay (image en lcher de ballons

cannon balls sign, golf balls sign).
Hnh nh dng k (miliary form).
Hnh nh dng nt th (coarse nodular form).
Nguyn nhn: t cc loi K thn, xng, gip, K t
bo nui, melanoma, tinh hon.
11/1/2014
85
UNG TH PHI TH PHT

DI CN THEO NG MU

11/1/2014
86
UNG TH PHI TH PHT

DI CN THEO NG MU
Di cn t Testicular teratocarcinoma
11/1/2014
87
UNG TH PHI TH PHT

DI CN THEO NG MU
Di cn t HCC
6 thng sau
Sanjeev Katyal, MD et al. Extrahepatic Metastases of Hepatocellular Carcinoma.

Radiology. 2000;216:698-703.
11/1/2014
88
UNG TH PHI TH PHT

DI CN THEO NG MU
Di cn to hang t Squamous cell

carcinoma ca ph qun gc (T).
Joon Beom Seo, MD et al. Atypical Pulmonary Metastases: Spectrum of Radiologic Findings.
Radiographics. 2001;21:403-417.
11/1/2014
89
UNG TH PHI TH PHT

DI CN THEO NG BCH HUYT
Hnh mng v cc ng tua ta v 2 rn phi.

ng Kerley B, A, C, D.
Hch rn phi ph i.
Nguyn nhn: t cc loi K v, d dy, gip.
11/1/2014
90
UNG TH PHI TH PHT


11/1/2014
91
UNG TH PHI TH PHT

Hnh nh bnh thng
1 nm sau: di cn theo bch

mch, TDMP

11/1/2014
92
UNG TH PHI TH PHT

Dy vch lin tiu thy
11/1/2014
93
UNG TH PHI TH PHT


11/1/2014
94
UNG TH PHI TH PHT

Jacques Rmy et al. Cours de Tomodensitometrie Thoracique. CHRU de Lille. 2005

11/1/2014
95
UNG TH PHI TH PHT

DI CN THEO NG PH QUN
Bronchioloalveolar carcinoma di cn theo ng ph

qun, biu hin bng nhng nt trung tm tiu thy
(cc mi tn).
11/1/2014
96
UNG TH PHI TH PHT

DI CN THEO NG PH QUN
Squamous cell carcinoma vi hnh

nh to hang
Vi nm sau: nt v khi to hang hai

bn
11/1/2014
97
CM N S CH CA QU BC S
Sng Seine nhn t thp Effel, 21/6/2005
11/1/2014
98
TI LIU THAM KHO
Richard Webb et al. Thoracic Imaging-Pulmonary & Cardiovascular Radiology. 2005

Wolfgang Dahnert, MD. Radiology Review Manual. 5thEditon. 2003
Jacques Rmy et al. Imagerie Thoracique. Socit Franaise de Radiologie - 2003
Jacques Rmy et al. Cours de Tomodensitometrie Thoracique. CHRU de Lille. 2005
Philippe Grenier et al. Imagerie Thoracique de l'adulte. 2e edition. 1996
Farnoosh Sokhandon, MD et al. Bronchogenic Squamous Cell Carcinoma.
Radiographics. 2003;23:1639-1643.
Joon Beom Seo, MD et al. Atypical Pulmonary Metastases: Spectrum of Radiologic
Findings. Radiographics. 2001;21:403-417.
J I Jung, MD et al. CT differentiation of pneumonic-type bronchioloalveolar cell
carcinoma and infectious pneumonia. British Journal of Radiology 74 (2001),490-494.
Jeremy J. Erasmus, MD et al. Solitary Pulmonary Nodules: Part I. Morphologic
Evaluation for Differentiation of Benign and Malignant Lesions. Radiographics.
2000;20:43-58.
Sanjeev Katyal, MD et al. Extrahepatic Metastases of Hepatocellular Carcinoma.
Radiology. 2000;216:698-703.
11/1/2014
99

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CHN ON HNH NH

KHOA CHN ON HNH NH

U ph qun-phi rt nguy him, ch c 15% sng st

Trong thuc l c Carcinogenic polycyclic

Theo gii phu: c hai loi.

K PH QUN-PHI TH TRUNG TM (80%)

K PH QUN-PHI TH TRUNG TM (80%)

Vim phi sau tc nghn (obstructive pneumonia):

K PH QUN-PHI TH TRUNG TM (80%)

Khi u rn phi, thng km theo xp phi to du

Weissleder et al.Diagnostic Imaging Expert.1998

K PH QUN-PHI TH TRUNG TM (80%)

S Goldens sign: Small cell carcinoma

Weissleder et al.Diagnostic Imaging Expert.1998

K PH QUN-PHI TH TRUNG TM (80%)

K PH QUN-PHI TH TRUNG TM (80%)

K PH QUN-PHI TH TRUNG TM (80%)

K PH QUN-PHI TH TRUNG TM (80%)

TNG QUAN GIA U V PH QUN

TNG QUAN GIA U V PH QUN

TNG QUAN GIA U V PH QUN

Chi trong lng kh qun, ph qun

Hch trung tht c xem l ph i

Khi u (T) xm ln khoang m trc carina, xm ln TM ch trn vi

K PH QUN-PHI TH NGOI BIN (20%)

Tn thng hnh ng tin (coin lesion);

K PH QUN-PHI TH NGOI BIN (20%)

Nhng du hiu gi c tnh

Sebastian Lange, MD et al. Radiology of Chest Diseases. 2nd Edition, 1998

K PH QUN-PHI TH NGOI BIN (20%)

Spiculated mass vi Pleural tail sign:

Weissleder et al.Diagnostic Imaging Expert.1998

K PH QUN-PHI TH NGOI BIN (20%)

Pleural tail sign:

K PH QUN-PHI TH NGOI BIN (20%)

B hnh gai, hang thnh dy khng u, pleural tail sign,

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

Spiculated edge: Squamous cell carcinoma

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

K PH QUN-PHI TH NGOI BIN (20%)

LIN QUAN GIA KCH THC V C TNH

Tn thng bt thuc < 15HU: gi lnh tnh.

Wolfgang Dahnert, MD. Radiology Review Manual. 5thEdition. 2003

NH LUT NHN I TH TCH

Th tch ca mt khi u tng gp i khi ng knh

NH LUT NHN I TH TCH

1 thng: Ung th t bo nh xm ln (aggressive small cell

Wolfgang Dahnert, MD. Radiology Review Manual. 5thEdition. 2003

NH LUT NHN I TH TCH

nh lut ny ch c gi tr tin on dng 65% cc trng

Wolfgang Dahnert, MD. Radiology Review Manual. 5thEdition. 2003

To gc t vi thnh ngc (cc mi tn trng), xa lp m ngoi mng

Tip xc vi thnh ngc > 3cm, to gc t vi thnh ngc (cc mi tn

Tip xc vi thnh ngc L=5cm,

Hy cung sn v u thnh ngc.

Tip xc vi thnh ngc L=5,6cm, D=8,7cm.